Healthcare Provider Details

I. General information

NPI: 1548787930
Provider Name (Legal Business Name): LIMB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 N 44TH ST
PHOENIX AZ
85018-7206
US

IV. Provider business mailing address

637 E COTTONWOOD LN
CASA GRANDE AZ
85122-2023
US

V. Phone/Fax

Practice location:
  • Phone: 602-900-1733
  • Fax: 602-900-1759
Mailing address:
  • Phone: 520-413-1554
  • Fax: 520-413-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVE SHARMA
Title or Position: MEMBER/OWNER
Credential: CP
Phone: 520-413-1554